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Minimally Invasive Surgery

Commonwealth OB-GYN

OB-GYNs located in Brookline Village, Brookline, MA

With advancing technology, the doctors at Commonwealth OB-GYN can provide less invasive options to treat many gynecologic conditions to effect the same as or better outcomes with an easier recovery than the invasive procedures of the past. Minimally invasive surgeries using hysteroscopic and laparoscopic techniques allow the team to perform many of the same surgeries, including hysterectomy, that in the past involved major abdominal incisions and more significant recovery time. Surgeries are done at Brigham and Women’s Hospital. Please call to make an appointment.

Minimally Invasive Surgery Q & A

What is laparoscopy?

Laparoscopy uses a laparoscope, a slender, lighted telescope with a camera, that your doctor inserts into the abdomen through a small incision.

Laparoscopy is conducted to diagnose a condition such as endometriosis or perform surgeries. Using instruments inserted through multiple incisions, the surgeon can remove ovarian cysts, tie your tubes or perform a hysterectomy.

Laparoscopy has several advantages over open surgery, including a shorter healing time, less pain, less blood loss, and fewer scars.


When is laparoscopy recommended?

Your doctor may opt to use laparoscopy as a diagnostic tool. Laparoscopy offers a minimally invasive way to learn about the following conditions:

  • Endometriosis
  • Uterine fibroids
  • Ovarian cysts or tumors
  • Abnormal uterine bleeding
  • Ectopic pregnancy
  • Pelvic pain


What is the recovery after a laparoscopy like?

After surgery, it’s normal to have a sore abdomen, cramping, or pain around the cuts the doctor made (incisions) for four days or so. You can expect to feel better and stronger each day, although you may get tired quickly and need pain medicine for a few days. Some patients can return to work the day after surgery, whereas others need a few days to a few weeks to recover before going back to work.

Sometimes pressure from the gas used during surgery causes other side effects. You may have pain in your neck or shoulders or feel pressure on your bladder and need to urinate more often than usual. These side effects should go away in fewer than four days.


What is hysteroscopy?

Hysteroscopy is a procedure to examine the inside of the uterus. A thin instrument is inserted through the cervix with a lens, a light source, and a camera to examine the uterine cavity.

The most common application of hysteroscopy is to examine abnormal bleeding possibly caused by polyps or fibroids or cancerous growths. The hysteroscope is also used as a form of treatment to remove the problematic cause.

After the procedure, you may have some cramping, similar to menstrual pain for a couple of days. You may also experience watery or bloody discharge for up to four weeks.

What is a hysterectomy?

A hysterectomy is performed to remove the uterus. There are several types. A partial hysterectomy is a procedure to remove the uterus, leaving the cervix intact; a total hysterectomy is the removal of the uterus and cervix.  Often, the fallopian tubes are also removed.

A total hysterectomy with bilateral salpingo-oophorectomy is the most extensive form of hysterectomy and includes removal of the uterus, ovaries, and fallopian tubes. Post-surgery, you may require additional care, such as hormone replacement therapy.

A radical hysterectomy is a surgery to remove the uterus, cervix, and upper portion of the vagina in the case of some cancers. Other surgeries remove only the ovaries or fallopian tubes.


Why would I need a hysterectomy?

A hysterectomy may be part of your treatment plan when conservative approaches don’t alleviate pelvic problems, including:

  • Uterine fibroids
  • Heavy or unusual vaginal bleeding
  • Uterine prolapse
  • Endometriosis
  • Adenomyosis
  • Cancer (or pre-cancer) of the uterus, cervix, ovary or endometrium


After a hysterectomy, your periods stop, and you can’t get pregnant.


What happens during a hysterectomy?

In most cases, your Commonwealth OB-GYN doctor performs a less-invasive hysterectomy either through your vagina or with a laparoscope. These surgical procedures allow faster recovery with less discomfort than a traditional hysterectomy performed through a larger incision in your abdomen.

The abdominal hysterectomy option involves an incision in the lower abdomen in order to remove the uterus.  With a vaginal approach, the only incision is inside the vagina.

For a laparoscopic hysterectomy, your doctor uses instruments placed through several small abdominal incisions to remove the uterus, usually through the vagina.  Most procedures are done with general anesthesia.


What is recovery like after a hysterectomy?

Depending on the extent of your surgery and type of procedure, you may go home the same day or remain in the hospital for one to two days. Once you return home, rest and avoid heavy lifting for four to six weeks.

To have all your questions about minimally invasive surgical options answered by the all-female team at Commonwealth OB-GYN, schedule a consultation by phone.